Community and Public Health
Introduction to Public Health
Health- is a state complete physical, mental, and
social well-being and not merely absence of disease,
(WHO,1995)
Public Health (nation’s health) -is the science and art
of preventing disease, prolonging life, promoting
health and efficiency through organized community
effort for the sanitation of the environment control, of
communicable disease, the education of individuals in
personal hygiene.
PREVENT, PROMOTE, PROTECT
Noncommunicable – lifestyle disease (hypertension,
disease develop cause by multi factors)
Communicable – infectious disease (we need to break
the chain, identify the weakest link, make
intervention)
Evolution of Public Health
a.k.a Community MEDICINE; Community Health,
Preventive Medicine, Hygiene
 Late 19th Century: a package of sanitary and
industrial safety measures
Services:
-Assurance of safe water supply
-Sanitary disposal of waste
-Clearance of slums
-Improving the work environment and working
conditions of industrial workers
 Early 20th Century: inclusion od measures for
prevention of communicable disease
Services:
-Immunization(prophylaxis or vaccination):
chlorella, smallpox, rabies, typhoid, anthrax, etc.
-Control vectors(arthropods or insects) and
reservoirs of infection(natural habitat of
organism)
 1920: full spectrum of prevention &
promotive service was incorporated
Services:
-Maternal and child health
- Family planning
-School health
-Nutrition Promotion
-Mental health
-Health education
* Primary health centers and subcenters were
constructed to provide the health services.
 Early 1960’s – education of the public not to
take risky lifestyles was included upon
realization of the role of risk factors in the
causation of non-communicable diseases
particularly chronic degenerative disease like

hypertension, heart disease, diabetes,
cancers, ulcerative colitis, etc.
1981: putting health care service in the hands
of every person regardless of nationality,
caste, creed, educational status and economic
stature in order for him/her to lead a socially
and economically productive life.
Other Terminologies Synonymous with
Public Heath/Community Health
- Hygiene
-Preventive Medicine
-Social Medicine
Roles of Medical Technologist in
Public Health

Health Programs/Projects Field
Coordinator
 Health Programs/Projects Monitoring
Officer
 Health Programs/Projects Evaluation
Officer
 Field Epidemiologist (outbreak
investigation; contact tracing;
surveillance)
Sanitation Inspector

PHILIPPINE HEALTH CARE DELIVERY
SYSTEM
2 COMPONENTS:
1. PUBLIC SECTOR
- National: DOH
- Local: LGU
*can be in the city or municipality
*includes health centers or barangay health
stations
2. PRIVATE SECTORS
- Clinics
- Hospitals
- Health insurances
- Manufacturing of medicines
- Vaccines
- Medical supplies
-Equipment
- Nutrition products
-Research & development
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Community and Public Health
DEPARTMENT OF HEALTH
History:
1. Pre-Spanish and Spanish Periods (before
1898)
-traditional health care (herbs & rituals
-dispensary of indigent patients of Manila
(established by Fr, Juan Clemente become San
Juan De Dios Hospital)
-MEDICUS TITULARES (provincial health workers)
-Superior Board of Health & Charity, 1888
2. June 23, 1898
- creation of E. Aguinaldo government of
Department of Public Works, Education & Hygiene
3. September 29, 1898
- general order no. 15 established the Board of
Health for the City of Manila
(taking care the American soldiers/troops; Dr.
Padro de Tavera and Dr. Aristone Bautista Lim + 3
American doctors/surgeon – 1st Provincial Board)
August 26, 1899 – BOH was abolished
Dr. Guy Edie – 1st Commissioner of Health
(registration of certificates; birth, death and
marriages)
4. July 1, 1901 (extended)
- act no. 157: Board of Health of Philippine
Islands (local health board of the country)
- acts no. 307 & 308: provincial and municipal
boards (dec. 2, 1901)
5. October 26, 1905
- act no. 1407; established of Bureau of Health
(Department of Interior; Dr. Victor Heiser – 1st
Director oh BOH)
6. 1912
- act no. 2115 (Fajardo Act) “health fund” for
travel and salaries (Rural Health Law –
strengthening the health & dental services in the
rural area)
7. 1915
- act no. 2568: from BOH to Philippine Health
Service ”semi-military system of public health
administration”
8. August 2, 1916
- act 2711 w/c included the Public Health Law of
1917
9. 1932 – reorganize (main purpose) dept,
bureaus, offices
- act no. 4007: Reorganization Act of 1932
- PGH commissioner of health & public welfare, 5
examining boards (medical, dental,
pharmaceutical, nursing, optical)
PGH (1907) - 1100 charity beds; 400 private
beds
- idea building PGH introduced by: Dean C.
Worcester
- Taft Avenue, Ermita, Manila
-Tertiary State-owed Hospital
- UP Manila
- National University Hospital
- National Government Referral Center
10. May 31, 1939
- commonwealth act no. 430 created the
Department of Public Health & Welfare, but was
only completed through E.O no. 317, Jan. 7, 1941
(DPHW formalized)
 Bureau of Quarantine
 Health Department of Chartered Cities
 Provincial, Cities and Municipal Hospitals
 Dispensaries and Clinics
 Slaughter Houses
 Public Markets
- Dr. Jose Fabella became its first secretary
(Fabella Hospital)
- Santa Cruz Manila
- National Maternal Hospital
- Tertiary Hospital (Mothers & Newborn)
11. October 4. 1947
- E.O no. 94: Post war reorganization of DPWH
- resulted in the split of Department of Public
Welfare (w/c became Social Welfare
Administration) and Public General Hospital to the
Office of the President
-another split between curative
(Bureau of Hospitals) & preventive services
(Bureau of Health)
-Nursing Service Division was also established
12. January 1, 1951
- conversion of Sanitary District to Rural Health
Unit, carrying the ff. services:
 Maternal & child health
 Environmental health
 Communicable disease
 Vital statistics
 Medical care
 Health education
 Public health nursing
- resulted in passage of Rural Health Act of
1954 (RA 1082)
- 1300 rural health units
- one rural health unit in diff. municipality all
over the Philippines (Preventive, Curative,
Promotional Health Work
13. 1970
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Community and Public Health
- conceptualization of the Restructured Health
Care Delivery System (primary, secondary, &
tertiary levels of care)
14. June 2, 1978
- P.D. 1937 renamed DOH to Ministry of Health
during the Martial Law
- Sec. Gatmaitan was the 1st minister of health
15. December 2, 1982
- E.O. 851 reorganized Ministry of Health as an
integrated health care delivery system through
the creation of Integrated Provincial Health Office,
combining the public health and hospital
operations under the PHOs.
16. April 13, 1987
- E.O. no. 119: MOH was back in the name
Department of Health by President Cory Aquino
17. October 10, 1991
- RA 7160 known as the Local Government Code:
all structures, personnel & budgetary allocation
from the provincial health level down to the
barangay were devolved to the LGU to facilitate
health service delivery
- national policy & regulatory institution
- leadership in formulation, monitoring, &
evaluation of health policies, plans, & programs
- serve as advocate in health policies, plans, &
programs
From PROVINCIAL TO LOCAL GOVERNMENT
(devolution/devolved health sector)
18. May 24, 1999
- E.O. 102c “Redirecting the Functions &
Operations of the DOH” by Pres. Joseph Estrada
19. 1999-2004
-Development of the Health Sector Reform
Agenda (HRSA) - Improved the way health care is
delivered, regulated, & financed
 Public health
 Hospital reform
 Health financing
 Health regulation
 Health systems
VISION
The DOH is the leader, staunch advocate and
model in promoting health for all in the
Philippines
MISSION
Guarantee equitable, sustainable and quality
health for all Filipinos, especially the poor and
shall lead the quest for excellence in health
20. 2005 to present
- development of a plan to rationalize the
bureaucracy in an attempt to scale down including
the DOH
STRATEGIES FOR HEALTH PILLARS REFORMS
 Health financing
 Service delivery
 Regulation
 Governance
Formula 1 for health performance
accountability system (2009)
ROLES AND FUNCTIONS
1. LEADERSHIP IN HEALTH
2. ENABLER & CAPACITY BUILDER
- innovate new strategies in health
- monitoring & evaluation of national health
policies, plans & programs
- ensure highest achievable standards of quality
HC, health promotion & health protection
3. ADMINISTRATOR OF SPECIFIC SERVICES
- manage selected national & sub-national health
facilities & hospitals w/ modern facilities that shall
serve as referral centers
- administer direct services for emerging health
concerns
-emergency response services in disaster amd
epidemics
Alma Ata Declaration of 1978
- International Conference on Primary Health
Care, Alma-Ata, USSR, 6-12 September 1978
(expressing the need for urgent action by all
governments, all health and development
workers, and the world community to protect and
promote the health of all the people in the world
Universal Health Care (UHC)
- all Filipinos are guaranteed equitable access to
quality and affordable health care goods and
services, and protected against financial risk.
President Duterte signed R.A 11223 or the
Universal Health Care Act into law last February
20, 2019
FOURmula ONE for Health
- 2005-2010 implementation frame works for
health sector reform in the Philippines
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Community and Public Health
Goals of F1
 Better health outcomes
 More responsive health system
 More equitable healthcare financing
Objective of F1
- aimed at achieving critical reforms with speed,
precision and effective coordination directed at
improving the quality, efficiency, effectiveness and
equity of the Philippines health system in a manner
that is felt and appreciated by Filipinos, especially the
poor.
Components of FOURmula 1 for Health
1. Health Financing - to secure more, better and
sustained investments in health to provide
equity and improve health outcomes,
especially for the poor.
2. Health Regulation - assuring access to quality
and affordable health products, devices,
facilities and service, especially those
commonly used by the poor.
3. Health Service Delivery - aimed at improving
the accessibility and availability of basic and
essential health care for all, particularly the
poor. This shall cover all public and private
facilities and services.
4. Good Governance in Health - to improve
health systems performance at the national
and local levels.
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